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Commitments and contingencies - Narrative (Details) - USD ($)
$ in Thousands
 1 Months Ended 12 Months Ended
Jul. 31, 2022
Dec. 31, 2022
Jan. 31, 2023
Dec. 31, 2021
May 29, 2020
Apr. 29, 2020
Apr. 20, 2017
Jun. 30, 2016
Other Commitments                
Accrued royalties   $ 40,546   $ 35,679        
Wellcome Trust                
Other Commitments                
Development milestone payment obligations   2,500           $ 800
Wellcome Trust | Maximum                
Other Commitments                
Development milestone payments which the entity is obligated to pay   14,500            
Censa                
Other Commitments                
Asset acquisition, milestone, amount         $ 217,500      
Asset acquisition, development and regulatory milestones         109,000      
Asset acquisition, net sales milestone         160,000      
Asset acquisition, initial milestone         $ 30,000      
Agilis Merger Agreement | Marathon                
Other Commitments                
Development milestone payment obligations             $ 50,000  
SMA License Agreement | SMA Foundation                
Other Commitments                
Royalty expense   28,500            
Royalty payments   24,500            
Accrued royalties   4,000            
SMA License Agreement | SMA Foundation | Maximum                
Other Commitments                
Potential royalty payments due on net product sales   52,500            
Agilis                
Other Commitments                
Development milestone payments which the entity is obligated to pay   40,000            
Net sales amount           $ 150,000    
Milestone obligation payments made $ 50,000              
Development milestone obligation payments made   $ 2,400            
Agilis | Minimum                
Other Commitments                
Product sales (as a percent)   2.00%       2.00%    
Agilis | Maximum                
Other Commitments                
Development milestone payment obligations   $ 60,000            
Priority review voucher amount   535,000            
Net sales amount   $ 150,000            
Product sales (as a percent)   6.00%       6.00%    
Development milestone payment obligations, net of cancellation and forfeiture   $ 20,000            
Contingent liability, milestone, potential achievements, priority review voucher amount, net of cancellation and forfeiture   361,000            
Agilis | Agilis Merger Agreement                
Other Commitments                
Development milestone payment obligations   40,000            
Agilis | Rights Exchange Agreement                
Other Commitments                
Contingent liability cancellation and forfeiture of potential milestone payments   174,000            
Development milestone payment obligations, cancellation and forfeiture   37,600            
Contingent liability, cancellation and forfeiture   211,600            
BioElectron | Maximum                
Other Commitments                
Development milestone payment obligations   $ 200,000            
Subsequent Event [Member] | Censa                
Other Commitments                
Development milestone payment obligations     $ 30,000